Abdominal Distention (Crisis) of R-CPD Including Before and After Botox Injection
One of the primary symptoms of R-CPD (inability to burp) is bloating. Bloating is often accompanied by actual abdominal distention due to excess air in both stomach and intestines. Since the person is unable to burp, air must now pass through the entire GI tract and be dispelled as flatulence.
Gastric Air Bubble (1 of 3)
Bloated Abdomen (2 of 3)
Non-bloated Abdomen (3 of 3)
A Rare “abdominal crisis” Due to R-CPD
This young man had an abdominal crisis related to R-CPD. He has had lifelong symptoms of classic R-CPD: inability to burp, gurgling, bloating, and flatulence. During a time of particular discomfort, he unfortunately took a “remedy” that was carbonated. Here you see a massive stomach air bubble. A lot of his intestines are air-filled and pressed up and to his right (left of photo, at arrow). The internal pressure within his abdomen also shut off his ability to pass gas.
X-Ray of Abdominal Bloating (1 of 2)
Original X-Ray (2 of 2)
Abdominal Distention Caused by R-CPD
Bloating and abdominal distention before botox injection for inability to burp (1 of 2)
Resolved, one month after botox, with burping restored (2 of 2)
Can’t Burp: Progression of Bloating and Abdominal Distention – a Daily Cycle for Many with R-CPD
This young woman has classic R-CPD symptoms—the can’t burp syndrome. Early in the day, her symptoms are least, and abdomen at “baseline” because she has “deflated” via flatulence through the night. In this series you see the difference in her abdominal distention between early and late in the day. The xray images show the remarkable amount of air retained that explains her bloating and distention. Her progression is quite typical; some with R-CPD distend even more than shown here especially after eating a large meal or consuming anything carbonated.
Side view of a bloated abdomen (1 of 6)
Front view (2 of 6)
Greater Distention (3 of 6)
Front view of bloating stomach (4 of 6)
X-ray of trapped air (5 of 6)
Side view (6 of 6)
Shortness of Breath Caused by R-CPD
Persons who can’t burp and have the full-blown R-CPD syndrome often say that when the bloating and distention are particularly bad—and especially when they have a sense of chest pressure, they also have a feeling of shortness of breath. They’ll say, for example, “I’m a [singer, or runner, or cyclist or _____], but my ability is so diminished by R-CPD. If I’m competing or performing I can’t eat or drink for 6 hours beforehand.” Some even say that they can’t complete a yawn when symptoms are particularly bad. The xrays below explain how inability to burp can cause shortness of breath.
X-ray of trapped air (1 of 2)
Side view (2 of 2)
The Daily Inflation-Deflation Cycle for R-CPD
Deflated Abdomen (1 of 4)
Bloated lateral view (2 of 4)
Deflated abdomen (3 of 4)
R-CPD distention (4 of 4)
Children with R-CPD Need Champions
This four-year-old is an example of the many young children who fulfill the criteria for a diagnosis of R-CPD, but who cannot find a doctor to help. Her parents also say the following: “She was impossible to burp as an infant. She only eats small amounts, stopping due to discomfort, and is falling behind developmental markers (especially weight). Her abdomen blows up like a balloon each day. She requires daily laxative use, and passes a long stream of flatulence before moving her bowels.”
This child precociously describes what is clearly throat nausea, and speaks of trouble breathing and too much “throat water.” When she has hiccups (once a week or so), they hurt a lot.
For her age, this child has undergone significant testing and dietary manipulations, even medications, without any significant benefit. The friction and delay in the medical system of this family’s large city is so great, and the child’s (and her parents’) distress so intense that they are traveling hundreds of miles for the care of a physician who will treat expeditiously based upon the syndrome alone.
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R-CPD in X-ray Images | Misery vs. Crisis from Inability to Burp
Why do persons with R-CPD experience such daily misery? These X-ray images provide the explanation, as well as the rare “abdominal crisis” in this group is also explained.
In a new video format, Dr. Bastian will discuss various photo essays found across Laryngopedia, and provide in-depth descriptions on their origins and what is going on behind the scenes during the time of capture.